Basic Science & Molecular Pathogenesis of Lung Cancer


Presented by: Alex A. Adjei, MD, PhD, FACP

Covered by: Ivy Riano, M.D., Research Chief Fellow, Hematology and Oncology Unit, Dartmouth Cancer Center, Lebanon, NH.


adjei MD
Alex A Adjei MD PhD FACP Chief Cancer Institute Cleveland Clinic

Dr. Alex A. Adjei, chair of Cleveland Clinic Taussig Cancer Institute, discusses how an emerging generation of genomic technologies is redefining cancer screenings, giving rise to a new paradigm of multi-cancer early detection (MCED) [1]. MCED detects signals for multiple cancers from cell-free DNA (cfDNA) or other circulating analytes. In these assays, genomic sequencing is often combined with machine learning to detect signals from cfDNA methylation, mutations, or fragmentation, as well as proteins or other circulating analytes [2]. Dr. Adjei discusses the implications of the PATHFINDER study results on MCED. This was the first return-of-results study to evaluate how these test results affect diagnostic and care pathways in a screening population [3].


During this session, the importance of therapeutic drug monitoring (TDM) is also discussed. The concept of TDM refers to individualizing drug dosage by maintaining blood levels of a particular drug within a narrow therapeutic range [4]. By combining knowledge of pharmaceutics, pharmacokinetics, and pharmacodynamics, Dr. Adjei highlights that the integration of tumor and host factors in predicting drug development and toxicity is critical. Moreover, the integration of the relatively new CRSPR-based tools offers an enormous array of possible applications for exploring gene function that changes cancer research and treatment [5]. The session concludes by highlighting how the rapid progress in CRSPR cancer trials is paving the way for personalized treatments.



  1. Hackshaw et al. Cancer Cell 2022.
  2. Klein et al. Ann Onc 2021.
  3. Deb Schrag. ESMO 2022.
  4. Mueller-Schoell et al. Eur J Clin Pharmacol 2021.
  5. Katti et al. Nature. 2022.



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